This volume is the most comprehensive guide for counselors and front-line professionals who work with the chemically dependant in a variety of settings. It is a very basic introduction that guides the counselor through treatment from A to Z. It is also a popular core text for courses in addiction/substance abuse counseling. Presents the state-of-the-art tools necessary to deliver outstanding treatment and meet the highest standards demanded by accrediting bodies. Chapters cover the gamut of treatment issues, including developing the therapeutic alliance, screening, detoxification, biopsychosocial assessment, dual-diagnosis, patient orientation, treatment planning, individual therapy, group therapy, case management, crisis intervention, referral, record keeping, discharge planning, and referral. Author Robert R. Perkinson provides case studies and step-by-step instructions with clear explanations and procedures that counselors need to use in all phases of patient care. One of the key features of this volume is the inclusion of over 50 appendices, which includes screening questionnaires, scales, history assessments, personal recovery plans, in-patient and out-patient schedules, and many, many more. The new edition will add more appendicies and update existing ones.

Preface

Ch 1. The First Contact

Treatment Works

The Motivational Interview

How to Develop the Therapeutic Alliance

Questions to ask the Adult Client

Questions to ask the Adolescent Client

Questions to ask the Parent/Caregiver

What to do if There are One or More Red Flags

Natural History of Addiction

How to Diagnose an Addiction Problem

How to Intervene

How to Assess Motivation

Motivating Strategies

Ch 2. The Drugs

CNS Depressants

The Hallucinogens

The Reinforcing Properties of Drugs

Tolerance and Dependence

Cross-tolerance

Alcohol

Alcohol-Induced Organic Mental Disorders

Sedatives, Hypnotics and Anxiolytics

Opioids

Cocaine and Amphetamines

Cannabis

Inhalants

Nicotine

Polysubstances

Treatment Outcome

Ch 3. The First Few Hours of Treatment

The First Few Hours

How to Greet Clients

Examples

How to Handle Family Members

Beginning the Therapeutic Alliance

The Importance of Trust

Dealing with Early Denial

Example of an Initial Contact

The Initial Assessment

Referral

How to Conduct a Crisis Intervention

Diagnostic and Statistical Manual

Diagnosis: Drug Abuse

Diagnosis: Chemical Dependency

Pathological Gambling

How to Determine the Level of Care Needed

Criteria for Inpatient Treatment (Adults)

Criteria for Outpatient Treatment (Adolescents)

Treatment of Inpatient Treatment (Adolescents)

The Client's Reaction to Intoxication

What to do with an Intoxicated Client

Detoxification

How Clients React to Detoxification

The AMA Threat

How to use the AMA Team

How to use the In-House Intervention

How to respond to Clients who Leave AMA

Ch 4. The Biopsychosocial Interview

How to Conduct the Interview

A Sample Biopsychosocial Interview

Ch 5. The Treatment Plan

How to Build a Treatment Plan

The Diagnostic Summary

The Problem List

How to Develop a Problem List

Goals and Objectives

How to Develop Goals

How to Develop Objectives

How to Select Goals, Objectives and Interventions

Treatment Plan Review

Documentation

How to Write Progress Notes

Formal Treatment Plan Review

Ch 6. Individual Treatment

The Therapeutic Alliance

How to Develop a Therapeutic Alliance

How to be Reinforcing

How to Use Empathy

Transference and Countertransference

How to be Confrontive

Behavior Therapy

How Clients Learn

Habits

Changing a Habit

What is Reinforcement?

What is Punishment?

The Behavior Chain

The Importance of Reinforcement

How to Use Punishment

When a Client Breaks a Rule

Why we Concentrate on Behavior Therapy

Cognitive Therapy

How Chemically Dependent People Think

Defense Mechanisms

Applying Cognitive Therapy

Automatic Thoughts

How to Correct Inaccurate Thoughts

Uncover the Thoughts and Feelings

Score the Inaccurate Feelings

Getting the Thoughts Accurate

Score the Accurate Feelings

Compare Inaccurate and Accurate Thoughts and Feelings

Uncovering the Themes

Solidifying Accurate Thinking

Interpersonal Therapy

How to Develop Healthy Relationships

Building a Relationship with a Higher Power

Developing a Relationship with Self

Building Relationships with Others

How Clients Use Feelings Inappropriately

How Clients Learn Relationship Skills

How to Change Relationships

How to Handle Grief

How to Choose the Therapeutic Modality

Ch 7. Group Therapy

Benefits of the Group Process

The Preparation Statement

The Agenda Group

How to Choose the Order of the Agenda

How to Give Good Feedback

How to Receive Feedback

How to Run the Group

How to Know Which Therapy to Use

The Honesty Group

The Euphoric Recall Group

How to Uncover Euphoric Recall

How to Help the Clients See the Truth

The Reading Group

The Relapse Prevention Group

The Spirituality Group

The Childhood Group

How to Explore Early Parental Relationships

The Men and Women's Group

The Community Group

The Personal Inventory Group

Ch 8. The Contracts

The Chemical Use History

Honesty

Love, Trust and Commitment

Feelings

Relationship Skills

Addictive Relationships

Communication Skills

Self-Discipline

Impulse Control

Relapse Prevention

Stress Management

Ch 9. The Steps

The Committee

Step One

Step Two

Step Three

Step Four

Step Five

Ch 10. The Lectures

The Disease Concept

Defense Mechanisms

The Great Lie

Normal Development

Physical Addiction and Recovery

Alcoholics Anonymous

Feelings

Ch 11. Special Problems

The Psychiatric/Psychological Assessment

How to Develop the Treatment Plan

The Depressed Client

The Angry Client

Personality

The Antisocial Personality

The Borderline Client

The Narcissistic Client

The Anxious Client

The Psychotic Client

Acquired Immune Deficiency Syndrome

The Client with Low Intellectual Functioning

The Elderly Client

The Client with Early Childhood Trauma

Love in the Treatment Center

The Pathological Gambler

Ch 12. Adolescent Treatment

The Normal Adolescent

The Chemically Dependent Adolescent

The Adolescent Chemical Dependency Counselor

The Primary Elements in Adolescent Treatment

The Phases of Adolescent Treatment

Ch 13. The Family Program

The First Contact

How to Handle the Early AMA Risk

The Family Problems

Codependency

Guilt

Loss of Control

Shame

Caretaking

Enabling

Inability to Know Feelings

Inability to Know Wants

Lack of Trust

People Pleasing

Feelings of Worthlessness

Dependency

Poor Communication Skills

How to Treat Family Members

The Family Program Schedule

The Conjoint Session

Ch 14. The Clinical Staff

The Physician

The Psychologist/Psychiatrist

The Nurse

The Clinical Director

The Clinical Supervisor

The Chemical Dependency Counselor

The Rehabilitation Technician or Aide

The Activities Coordinator

Clinical Staffing

How to Present a Client

Team Building

Commitment to Co-Workers

Boundaries

Staff-Client Problems

What to do When a Client Does Not Like a Counselor

What to do When a Client Complains About a Rule

The Work Environment

Ch 15. The Good Counselor

Being Loving

Loving Counselors Enjoy Their Work

Loving Counselors do Not Become Overly Involved

Loving Counselors do Not Lie

Loving Counselors are Gentle

Good Counselors Love Themselves

Good Counselors are Sensitive

Good Counselors Have a Sixth Sense

Good Counselors do Not Become Overly Emotional

Active Listening

Good Counselors do Not Talk Too Much

Good Counselors Maintain Boundaries

Good Counselors are Patient

Good Counselors Have Effective Interpersonal Relationship Skills

Ch 16. Discharge Summary and Continuing Care

Outpatient Discharge Criteria

Inpatient Discharge Criteria

How to Develop a Discharge Summary

The Discharge Summary

Saying Good-Bye

Appendix 1 Cognitive Capacity Screening Examination

Appendix 2 Short Michigan Alcoholism Screening Test

Appendix 3 CAGE Questionnaire

Appendix 4 Psychoactive Substance Use Disorder

Appendix 5 Clinical Institute Withdrawal Assessment of Alcohol Scale

Appendix 6 Narcotic Withdrawal Scale

Appendix 7 Sample Biopsychosocial

Appendix 8 Chemical use History

Appendix 9 Honesty

Appendix 10 Love, Trust and Commitment

Appendix 11 Feelings

Appendix 12 Relationship Skills

Appendix 13 Addictive Relationships

Appendix 14 Communication Skills

Appendix 15 Self-Discipline

Appendix 16 Impulse Control

Appendix 17 Relapse Prevention

Appendix 18 Step One

Appendix 19 Step Two

Appendix 20 Step Three

Appendix 21 Step Four

Appendix 22 Step Five

Appendix 23 Adolescent Unit Level System

Appendix 24 Peer Pressure

Appendix 25 The Behavioral Contract

Appendix 26 Family Questionnaire

Appendix 27 Codependency

Appendix 28 Personal Recovery Plan

Appendix 29 Sample Discharge Summary

Appendix 30 Stress Management

Appendix 31 Hamilton Depression Rating Scale

Appendix 32 Biopsychosocial Assessment

Appendix 33 Anger Management

Appendix 34 Narcissism

Appendix 35 Honesty for Gamblers

Appendix 36 Step One for Gamblers

Appendix 37 Step Two for Gamblers

Appendix 38 Step Three for Gamblers

Appendix 39 Step Four for Gamblers

Appendix 40 Step Five for Gamblers

Appendix 41 Relapse Prevention for Gamblers

Appendix 42 Adolescent Unit Point System

Appendix 43 Results from the 2005 National Survey on Drug Use and Health

This volume is the most comprehensive guide for counselors and front-line professionals who work with the chemically dependant in a variety of settings. It is a very basic introduction that guides the counselor through treatment from A to Z. It is also a popular core text for courses in addiction/substance abuse counseling. Presents the state-of-the-art tools necessary to deliver outstanding treatment and meet the highest standards demanded by accrediting bodies. Chapters cover the gamut of treatment issues, including developing the therapeutic alliance, screening, detoxification, biopsychosocial assessment, dual-diagnosis, patient orientation, treatment planning, individual therapy, group therapy, case management, crisis intervention, referral, record keeping, discharge planning, and referral. Author Robert R. Perkinson provides case studies and step-by-step instructions with clear explanations and procedures that counselors need to use in all phases of patient care. One of the key features of this volume is the inclusion of over 50 appendices, which includes screening questionnaires, scales, history assessments, personal recovery plans, in-patient and out-patient schedules, and many, many more. The new edition will add more appendicies and update existing ones.

Table of Contents

Preface

Ch 1. The First Contact

Treatment Works

The Motivational Interview

How to Develop the Therapeutic Alliance

Questions to ask the Adult Client

Questions to ask the Adolescent Client

Questions to ask the Parent/Caregiver

What to do if There are One or More Red Flags

Natural History of Addiction

How to Diagnose an Addiction Problem

How to Intervene

How to Assess Motivation

Motivating Strategies

Ch 2. The Drugs

CNS Depressants

The Hallucinogens

The Reinforcing Properties of Drugs

Tolerance and Dependence

Cross-tolerance

Alcohol

Alcohol-Induced Organic Mental Disorders

Sedatives, Hypnotics and Anxiolytics

Opioids

Cocaine and Amphetamines

Cannabis

Inhalants

Nicotine

Polysubstances

Treatment Outcome

Ch 3. The First Few Hours of Treatment

The First Few Hours

How to Greet Clients

Examples

How to Handle Family Members

Beginning the Therapeutic Alliance

The Importance of Trust

Dealing with Early Denial

Example of an Initial Contact

The Initial Assessment

Referral

How to Conduct a Crisis Intervention

Diagnostic and Statistical Manual

Diagnosis: Drug Abuse

Diagnosis: Chemical Dependency

Pathological Gambling

How to Determine the Level of Care Needed

Criteria for Inpatient Treatment (Adults)

Criteria for Outpatient Treatment (Adolescents)

Treatment of Inpatient Treatment (Adolescents)

The Client's Reaction to Intoxication

What to do with an Intoxicated Client

Detoxification

How Clients React to Detoxification

The AMA Threat

How to use the AMA Team

How to use the In-House Intervention

How to respond to Clients who Leave AMA

Ch 4. The Biopsychosocial Interview

How to Conduct the Interview

A Sample Biopsychosocial Interview

Ch 5. The Treatment Plan

How to Build a Treatment Plan

The Diagnostic Summary

The Problem List

How to Develop a Problem List

Goals and Objectives

How to Develop Goals

How to Develop Objectives

How to Select Goals, Objectives and Interventions

Treatment Plan Review

Documentation

How to Write Progress Notes

Formal Treatment Plan Review

Ch 6. Individual Treatment

The Therapeutic Alliance

How to Develop a Therapeutic Alliance

How to be Reinforcing

How to Use Empathy

Transference and Countertransference

How to be Confrontive

Behavior Therapy

How Clients Learn

Habits

Changing a Habit

What is Reinforcement?

What is Punishment?

The Behavior Chain

The Importance of Reinforcement

How to Use Punishment

When a Client Breaks a Rule

Why we Concentrate on Behavior Therapy

Cognitive Therapy

How Chemically Dependent People Think

Defense Mechanisms

Applying Cognitive Therapy

Automatic Thoughts

How to Correct Inaccurate Thoughts

Uncover the Thoughts and Feelings

Score the Inaccurate Feelings

Getting the Thoughts Accurate

Score the Accurate Feelings

Compare Inaccurate and Accurate Thoughts and Feelings

Uncovering the Themes

Solidifying Accurate Thinking

Interpersonal Therapy

How to Develop Healthy Relationships

Building a Relationship with a Higher Power

Developing a Relationship with Self

Building Relationships with Others

How Clients Use Feelings Inappropriately

How Clients Learn Relationship Skills

How to Change Relationships

How to Handle Grief

How to Choose the Therapeutic Modality

Ch 7. Group Therapy

Benefits of the Group Process

The Preparation Statement

The Agenda Group

How to Choose the Order of the Agenda

How to Give Good Feedback

How to Receive Feedback

How to Run the Group

How to Know Which Therapy to Use

The Honesty Group

The Euphoric Recall Group

How to Uncover Euphoric Recall

How to Help the Clients See the Truth

The Reading Group

The Relapse Prevention Group

The Spirituality Group

The Childhood Group

How to Explore Early Parental Relationships

The Men and Women's Group

The Community Group

The Personal Inventory Group

Ch 8. The Contracts

The Chemical Use History

Honesty

Love, Trust and Commitment

Feelings

Relationship Skills

Addictive Relationships

Communication Skills

Self-Discipline

Impulse Control

Relapse Prevention

Stress Management

Ch 9. The Steps

The Committee

Step One

Step Two

Step Three

Step Four

Step Five

Ch 10. The Lectures

The Disease Concept

Defense Mechanisms

The Great Lie

Normal Development

Physical Addiction and Recovery

Alcoholics Anonymous

Feelings

Ch 11. Special Problems

The Psychiatric/Psychological Assessment

How to Develop the Treatment Plan

The Depressed Client

The Angry Client

Personality

The Antisocial Personality

The Borderline Client

The Narcissistic Client

The Anxious Client

The Psychotic Client

Acquired Immune Deficiency Syndrome

The Client with Low Intellectual Functioning

The Elderly Client

The Client with Early Childhood Trauma

Love in the Treatment Center

The Pathological Gambler

Ch 12. Adolescent Treatment

The Normal Adolescent

The Chemically Dependent Adolescent

The Adolescent Chemical Dependency Counselor

The Primary Elements in Adolescent Treatment

The Phases of Adolescent Treatment

Ch 13. The Family Program

The First Contact

How to Handle the Early AMA Risk

The Family Problems

Codependency

Guilt

Loss of Control

Shame

Caretaking

Enabling

Inability to Know Feelings

Inability to Know Wants

Lack of Trust

People Pleasing

Feelings of Worthlessness

Dependency

Poor Communication Skills

How to Treat Family Members

The Family Program Schedule

The Conjoint Session

Ch 14. The Clinical Staff

The Physician

The Psychologist/Psychiatrist

The Nurse

The Clinical Director

The Clinical Supervisor

The Chemical Dependency Counselor

The Rehabilitation Technician or Aide

The Activities Coordinator

Clinical Staffing

How to Present a Client

Team Building

Commitment to Co-Workers

Boundaries

Staff-Client Problems

What to do When a Client Does Not Like a Counselor

What to do When a Client Complains About a Rule

The Work Environment

Ch 15. The Good Counselor

Being Loving

Loving Counselors Enjoy Their Work

Loving Counselors do Not Become Overly Involved

Loving Counselors do Not Lie

Loving Counselors are Gentle

Good Counselors Love Themselves

Good Counselors are Sensitive

Good Counselors Have a Sixth Sense

Good Counselors do Not Become Overly Emotional

Active Listening

Good Counselors do Not Talk Too Much

Good Counselors Maintain Boundaries

Good Counselors are Patient

Good Counselors Have Effective Interpersonal Relationship Skills

Ch 16. Discharge Summary and Continuing Care

Outpatient Discharge Criteria

Inpatient Discharge Criteria

How to Develop a Discharge Summary

The Discharge Summary

Saying Good-Bye

Appendix 1 Cognitive Capacity Screening Examination

Appendix 2 Short Michigan Alcoholism Screening Test

Appendix 3 CAGE Questionnaire

Appendix 4 Psychoactive Substance Use Disorder

Appendix 5 Clinical Institute Withdrawal Assessment of Alcohol Scale

Appendix 6 Narcotic Withdrawal Scale

Appendix 7 Sample Biopsychosocial

Appendix 8 Chemical use History

Appendix 9 Honesty

Appendix 10 Love, Trust and Commitment

Appendix 11 Feelings

Appendix 12 Relationship Skills

Appendix 13 Addictive Relationships

Appendix 14 Communication Skills

Appendix 15 Self-Discipline

Appendix 16 Impulse Control

Appendix 17 Relapse Prevention

Appendix 18 Step One

Appendix 19 Step Two

Appendix 20 Step Three

Appendix 21 Step Four

Appendix 22 Step Five

Appendix 23 Adolescent Unit Level System

Appendix 24 Peer Pressure

Appendix 25 The Behavioral Contract

Appendix 26 Family Questionnaire

Appendix 27 Codependency

Appendix 28 Personal Recovery Plan

Appendix 29 Sample Discharge Summary

Appendix 30 Stress Management

Appendix 31 Hamilton Depression Rating Scale

Appendix 32 Biopsychosocial Assessment

Appendix 33 Anger Management

Appendix 34 Narcissism

Appendix 35 Honesty for Gamblers

Appendix 36 Step One for Gamblers

Appendix 37 Step Two for Gamblers

Appendix 38 Step Three for Gamblers

Appendix 39 Step Four for Gamblers

Appendix 40 Step Five for Gamblers

Appendix 41 Relapse Prevention for Gamblers

Appendix 42 Adolescent Unit Point System

Appendix 43 Results from the 2005 National Survey on Drug Use and Health